Vascular injury is a serious but rare complication of hip procedures. Most of vascular complications reported in articles occured in vessels around hip joint and femoral artery. To date, report of popliteal artery occlusion during or after total hip arthroplasty was absent. The authors have experienced one case of popliteal artery occlusion after total hip arthroplasty. It was suspected that the cause of occlusion of this particular case was a excessive maneuvering of limb during operation and then, artheromatous plaque fracture or thrombosis made occulusion in popliteal artery. Angiographic embolectomy using a catheter was performed and circulation of limb was recovered. To reduce the risk of vascular complications after total hip arthroplasty procedure, we recommend a thorough evaluation of lower extremity circulation in risky patient. And if a vascular insult is suspected either during or soon after the procedure, then a vascular consultation with arteriography including popliteal artery should be obtained urgently. Delay in treatment could result in a deleterious outcome.
Angiography ; Arthroplasty, Replacement, Hip* ; Catheters ; Embolectomy ; Extremities ; Femoral Artery ; Hip ; Hip Joint ; Humans ; Lower Extremity ; Popliteal Artery* ; Thrombosis ; Vascular System Injuries

No abstract available.
Forearm*

PURPOSE: This descriptive study was conducted to illuminate, from the nursing point of view, the infant care act, which was revised recently and to suggest a desirable direction of its enforcement decree and regulations. METHOD: This study was carried out through literature review and a collection of child care experts' opinions. RESULTS: The most remarkable changes in infant care act and the suggestions for a desirable direction of its enforcement decree and regulations are as follows: It can be said that the law on 'health', 'nutrition' and 'safety' for a child care center was improved to the level of act from the level of enforcement regulation. In the enforcement regulation on the distribution of nurses in child care centers, it is desirable that nurse's aids are excluded. It is recommended that every child care center should have a nurse or a health care manager and/or an emergency caretaker. In the curriculum for child care, the subjects on child health care should be an essential subject, not elective. CONCLUSION: Child care act should be reformed under the discipline of first priority to child health. Every nurse and nursing professor should have interest and earnestness in child care and conduct related studies.
Child ; Child Care ; Curriculum ; Delivery of Health Care ; Emergencies ; Humans ; Infant ; Infant Care* ; Infant* ; Jurisprudence ; Nursing* ; Social Control, Formal* ; Child Health

Purpose: To determine the incidence and the time to failure of repaired short external rotator muscles through aposterolateral approach in total hip arthroplasties; and to describe the correlation between failure of the repaired short external rotator muscles and the hip dislocation rate. Materials and Methods: Between January 2003 and October 2003, 51 patients (55 cases) were treated with primary, uncemented total hip arthroplasties. The average patient`s age was 51 years (33 men, 19 women). After the short external rotator muscles were repaired, two 26-gauge wires were stitched as a marker to the abductor tendons and short external rotator tendons. The distance between the two opposing reference points was less than 1.2 cm. The distance between the markers was determined on radiographs that were obtained 1 day, 2 weeks, and 3 months post-operatively. A distance of more than 2.5 cm, or an invisible one, indicated failure. Results: Of a total of 52 repaired short external rotator muscles, 45 (86.5%) failed. Twenty-five(48.1%) failed within the first day, 15 (28.8%) within 2 weeks, and 5 (9.6%) within 3 months post-operatively. Regardless of the time of failure of the repaired short external rotator muscles, postoperative hip dislocations did not occur. Conclusion: The repair of short external rotator muscles after total hip arthroplasties has a high failure rate and contributes little to the prevention of hip dislocations.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Hip ; Hip Dislocation ; Humans ; Incidence ; Male ; Muscles* ; Tendons

Cerebral white matter tracts are altered by a brain tumor. We report a case of gliomatosis cerebri where the diffusion tensor fiber tract passes through the tumor.
Brain Neoplasms ; Diffusion Magnetic Resonance Imaging ; Diffusion* ; Neoplasms, Neuroepithelial*

No abstract available.
Aneurysm* ; Bone Cysts* ; Giant Cell Tumors* ; Giant Cells*

Purpose: This study aimed to compare treatment options and outcomes based on peritoneal cancer index (PCI) among patients with peritoneal metastasis (PM) of advanced gastric cancer (AGC). Methods: Between January 2016 and July 2019, clinicopathological data of patients with AGC diagnosed with PM were reviewed. Different treatment methods were performed according to the PCI score: (1) group A (PCI ≤ 13) received cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) with postoperative intraperitoneal (IP) and systemic chemotherapy (n = 29), while (2) group B (PCI > 13) received IP chemotherapy with systemic chemotherapy (n = 22). Results: Clinical outcomes of 51 patients at the Dankook University Hospital were reviewed. Group A had a significantly lower mean PCI score (9.8 ± 6.9 vs. 32.6 ± 7.1, P < 0.01) than group B, with 25 patients (86.2%) achieving complete cytoreduction. Complications occurred in 16 patients (31.4%), none of who suffered mortality (group A: 11 patients, 37.9% vs. group B: 5 patients, 22.7%; P = 0.25). Among the morbidity, 5 cases (17.2%) and 2 cases (9.1%) exhibited a Clavien-Dindo grade greater than III in groups A and B, respectively (P = 0.04). Groups A and B had an overall median survival time of 34.0 and 16.0 months, respectively (P = 0.03). Conclusion Patients with PM of AGC received different treatments according to their PCI score. When accompanied with careful patient selection, our approach may be considered an acceptable option for the treatment of PM of AGC.

Purpose: This study aimed to compare treatment options and outcomes based on peritoneal cancer index (PCI) among patients with peritoneal metastasis (PM) of advanced gastric cancer (AGC). Methods: Between January 2016 and July 2019, clinicopathological data of patients with AGC diagnosed with PM were reviewed. Different treatment methods were performed according to the PCI score: (1) group A (PCI ≤ 13) received cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) with postoperative intraperitoneal (IP) and systemic chemotherapy (n = 29), while (2) group B (PCI > 13) received IP chemotherapy with systemic chemotherapy (n = 22). Results: Clinical outcomes of 51 patients at the Dankook University Hospital were reviewed. Group A had a significantly lower mean PCI score (9.8 ± 6.9 vs. 32.6 ± 7.1, P < 0.01) than group B, with 25 patients (86.2%) achieving complete cytoreduction. Complications occurred in 16 patients (31.4%), none of who suffered mortality (group A: 11 patients, 37.9% vs. group B: 5 patients, 22.7%; P = 0.25). Among the morbidity, 5 cases (17.2%) and 2 cases (9.1%) exhibited a Clavien-Dindo grade greater than III in groups A and B, respectively (P = 0.04). Groups A and B had an overall median survival time of 34.0 and 16.0 months, respectively (P = 0.03). Conclusion Patients with PM of AGC received different treatments according to their PCI score. When accompanied with careful patient selection, our approach may be considered an acceptable option for the treatment of PM of AGC.

BACKGROUND: Anemia is a common medical problem among the elderly; it is more frequent with advancing age. Anemia has been associated with adverse outcomes such as hospitalization, disability and mortality. However, the clinical significance of anemia in frail elderly patients, especially those admitted to acute care units, has not been investigated. METHODS: From May 2004 to April 2005, 308 patients 65 years of age or older, admitted to the Acute Elderly Care Unit at the Seoul National University Bundang hospital, were enrolled in the current study. Comprehensive geriatric assessment including medical, psychosocial and functional evaluation was performed by the geriatric team. Clinical and laboratory evaluations were carried out to determine the prevalence and etiology of the anemia. RESULTS: Anemia (Hb < 13 g/dL in male, < 12 g/dL in female) was identified in 149 patients (48.4%). The leading cause of anemia was anemia of chronic disease (N=75, 50.3%). Comparison between the anemic group and a control group was performed. Anemic patients were older, male, had an impaired functional status as well as a poor nutritional status. Moreover, the development of delirium was more frequent in the anemic group compared to the control group (11.0% vs 20.7%, p=0.021). In addition, the duration of hospitalization was significantly increased in patients with anemia (12.97+/-1.24 vs 18.07+/-1.77, p=0.019). However, in the multiple regression analysis, the presence of anemia did not affect the length of hospitalization as an independent factor. CONCLUSIONS: Anemia is common in frail elderly patients and has been associated with a poor clinical outcome. Although anemia was not an independent risk factor in the elderly patients, the anemia was associated with multiple co-morbidities, disability and frailty. Therefore, the presence of anemia in the elderly requires active investigation and management.
Aged ; Aged* ; Anemia* ; Chronic Disease ; Delirium ; Frail Elderly* ; Geriatric Assessment ; Hospitalization ; Humans ; Male ; Mortality ; Nutritional Status ; Prevalence ; Risk Factors ; Seoul

PURPOSE: The purpose of the study was to evaluate the effect of preoperative magnetic resonance imaging (MRI) on survival outcomes for breast cancer. METHODS: A total of 954 patients who had T1–2 breast cancer and received breast-conserving therapy (BCT) between 2007 and 2010 were enrolled. We divided the patients according to whether they received preoperative MRI or not. Survival outcomes, including locoregional recurrence-free survival (LRRFS), recurrence-free survival (RFS), and overall survival (OS), were analyzed. RESULTS: Preoperative MRI was performed in 743 of 954 patients. Clinicopathological features were not significantly different between patients with and without preoperative MRI. In the univariate analyses, larger tumors were marginally associated with poor LRRFS compared to smaller tumors (hazard ratio [HR], 3.22; p=0.053). Tumor size, histologic grade, estrogen receptor (ER), progesterone receptor (PR), hormonal therapy, and adjuvant chemotherapy status were associated with RFS. Larger tumor size, higher histologic grade, lack of ER and PR expression, and no hormonal therapy were associated with decreased OS. Tumor size was associated with LRRFS in the multivariate analyses (HR, 4.19; p=0.048). However, preoperative MRI was not significantly associated with LRRFS, RFS, or OS in either univariate or multivariate analyses. CONCLUSION: Preoperative MRI did not influence survival outcomes in T1–2 breast cancer patients who underwent BCT. Routine use of preoperative MRI in T1–2 breast cancer may not translate into longer RFS and OS.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Estrogens ; Humans ; Magnetic Resonance Imaging* ; Mastectomy, Segmental ; Multivariate Analysis ; Receptors, Progesterone